Liver Disorder

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Liver Disorder

The liver is one of the largest and most important organs in the human body, responsible for performing a wide range of vital functions. It plays a crucial role in processing nutrients, removing toxins from the body, and producing essential proteins that help to maintain the body’s overall health and well-being.

 

Unfortunately, like any other organ in the body, the liver is susceptible to a variety of disorders and diseases. These can range from minor conditions that can be easily treated to serious, life-threatening illnesses that can lead to liver failure and other complications.

Some of the most common liver-associated disorders include:

 

  • Jaundice: Jaundice is a condition in which the skin, eyes, and mucous membranes turn yellow due to the accumulation of bilirubin in the body. Bilirubin is a yellow pigment that is produced when red blood cells break down. It is processed by the liver and then excreted in the bile. When there is a problem with the liver, such as an obstruction in the bile duct or damage to the liver cells, bilirubin cannot be processed properly and accumulates in the body, resulting in jaundice.
  • Fatty liver disease: This is a condition in which excessive amounts of fat accumulate in the liver, causing inflammation and damage to the liver tissue. Fatty liver disease can be caused by a variety of factors, including alcohol consumption, obesity, high blood sugar levels, and high levels of fat in the blood.
    • Non-alcoholic Fatty Liver Disease (NAFLD)-Non-alcoholic Fatty Liver Disease (NAFLD) is a condition in which excess fat accumulates in the liver, leading to inflammation and scarring. This condition is often associated with obesity, type 2 diabetes, and metabolic syndrome. Symptoms of NAFLD may include fatigue, abdominal discomfort, and a feeling of fullness in the upper abdomen. Treatment for NAFLD involves weight loss, exercise, and a healthy diet.
    • Alcoholic Liver Disease (ALD)– Alcoholic Liver Disease (ALD) is a condition that occurs when excessive alcohol consumption damages the liver. Symptoms of ALD can include fatigue, abdominal pain, jaundice, and swelling of the legs and abdomen. Treatment for ALD involves quitting alcohol consumption, a healthy diet, and medication to manage symptoms.
  • Hepatitis: This is a viral infection that causes inflammation of the liver. There are several different types of hepatitis, including hepatitis A, B, and C. Hepatitis can be transmitted through contaminated food or water, as well as through unprotected sex or sharing needles with an infected person.
    • Autoimmune Hepatitis– Autoimmune hepatitis is a condition in which the body’s immune system attacks the liver, leading to inflammation and damage. The cause of autoimmune hepatitis is unknown, but it is believed to be related to genetics and environmental factors. Symptoms of autoimmune hepatitis can include fatigue, abdominal pain, joint pain, and jaundice. Treatment for autoimmune hepatitis involves medications to suppress the immune system and reduce inflammation.
    • Non-alcoholic steatohepatitis (NASH)-This is a condition in which excessive amounts of fat accumulate in the liver, causing inflammation and damage to the liver tissue. NASH is not caused by alcohol consumption, but rather by other factors such as obesity, high blood sugar levels, and high levels of fat in the blood.
  • Cirrhosis: This is a chronic condition that occurs when the liver is damaged to the point where it is unable to function properly. Cirrhosis can be caused by a variety of factors, including alcohol abuse, viral hepatitis, and certain medications.
  • Liver cancer: This is a type of cancer that originates in the liver. It can be caused by a variety of factors, including chronic viral hepatitis, excessive alcohol consumption, and exposure to certain toxins.
  • Hemochromatosis: This is a condition in which the body absorbs too much iron from food, leading to a build-up of iron in the liver and other organs. Hemochromatosis can lead to liver damage, cirrhosis, and other complications.
  • Wilson’s disease: This is a rare genetic disorder that causes the body to accumulate too much copper, leading to liver damage and other complications.
  • Cholangitis: Cholangitis is a condition characterized by inflammation of the bile ducts. The bile ducts are responsible for carrying bile from the liver and gallbladder to the small intestine for digestion.

Prevalence Rate in India of Liver Associated Disorders:

Liver diseases are a significant public health concern in India, with a high prevalence rate. The prevalence of liver diseases in India has been increasing in recent years due to various risk factors such as alcohol consumption, viral hepatitis infections, unhealthy lifestyle, and poor sanitation. According to studies, the prevalence of liver diseases in India ranges from 2% to 10%.

  • One of the most common liver diseases in India is non-alcoholic fatty liver disease (NAFLD), with a prevalence rate of up to 30% in the general population. NAFLD is often associated with metabolic risk factors such as obesity, diabetes, and dyslipidaemia. Other common liver diseases in India include viral hepatitis B and C infections, alcoholic liver disease, and liver cancer.
  • Viral hepatitis B and C infections are significant contributors to the burden of liver diseases in India. According to the World Health Organization (WHO), India has a high prevalence of viral hepatitis B and C infections, with an estimated 40 million people living with chronic hepatitis B and 6-12 million people living with chronic hepatitis C.
  • Alcoholic liver disease is also a significant contributor to the burden of liver diseases in India, particularly in men. The prevalence of alcohol-related liver diseases in India ranges from 2% to 30% in different parts of the country. In addition, liver cancer is also becoming increasingly prevalent in India, particularly in the northern states.
  • Overall, the prevalence rate of liver diseases in India is a cause for concern and highlights the need for effective prevention and management strategies. Early detection, lifestyle modifications, and timely medical interventions can help reduce the burden of liver diseases in India.

 

Common Causes of Liver Associated Disorders:

 

There are many different causes of liver diseases, some of which include:

  • Viral Hepatitis: Hepatitis B, C, and D viruses can cause inflammation of the liver leading to chronic liver diseases like cirrhosis and liver cancer.
  • Alcohol abuse: Prolonged and excessive alcohol consumption can cause liver damage leading to fatty liver, alcoholic hepatitis, and cirrhosis.
  • Lifestyle changes: Obesity, insulin resistance, and high cholesterol are some of the risk factors.
  • Autoimmune diseases: In this condition, the body’s immune system mistakenly attacks liver cells, leading to inflammation and damage.
  • Genetic disorder:
    • Hemochromatosis-This is a genetic disorder where the body absorbs too much iron, which can accumulate in the liver and other organs, leading to damage.
    • Wilson’s Disease: This is a genetic disorder where the body cannot properly metabolize copper, leading to its accumulation in the liver and brain, causing damage.
  • Drug-Induced Liver Injury: Certain medications and supplements can cause liver damage, especially if taken in high doses or over a long period of time.
  • Biliary Atresia: This is a rare condition where the bile ducts leading from the liver to the small intestine are absent or blocked, leading to liver damage and cirrhosis.
  • Other Causes: Other causes of liver diseases include hepatitis A and E viruses, exposure to toxins, metabolic disorders, and certain inherited conditions.

 

Common Symptoms of Liver associated disorders:

 

  • Jaundice: Jaundice is a yellowing of the skin and eyes caused by the build-up of bilirubin in the body. It is a common symptom of liver diseases and can be seen in conditions like hepatitis, cirrhosis, and liver cancer.
  • Abdominal pain: Pain in the upper right quadrant of the abdomen is a common symptom of liver diseases. It may be dull, achy, or sharp and may worsen with physical activity or eating.
  • Fatigue: Fatigue and weakness are common symptoms of liver diseases. This is due to the liver’s role in producing energy and metabolizing nutrients. In liver diseases, the liver may not be able to perform these functions adequately, leading to fatigue.
  • Nausea and vomiting: Nausea and vomiting are common symptoms of liver diseases, especially in acute conditions like hepatitis. This can be due to the build-up of toxins in the body and the inability of the liver to process them effectively.
  • Loss of appetite: Loss of appetite is a common symptom of liver diseases. This can be due to the build-up of toxins in the body, which can make eating unappealing, or due to the liver’s inability to produce the enzymes necessary for digestion.
  • Itching: Itching is a common symptom of liver diseases, especially in conditions like cholestasis. This is caused by the build-up of bile acids in the body, which can cause irritation and inflammation in the skin.
  • Swelling: Swelling in the legs, ankles, and feet can be a symptom of liver diseases. This is due to the build-up of fluid in the body, which can occur when the liver is not functioning properly.
  • Easy bruising and bleeding: Easy bruising and bleeding are common symptoms of liver diseases. This is due to the liver’s role in producing clotting factors, which help the blood to clot. When the liver is not functioning properly, clotting factors may not be produced adequately, leading to easy bruising and bleeding.
  • Mental confusion: Mental confusion and disorientation can be symptoms of liver diseases, especially in advanced stages of liver disease. This is due to the build-up of toxins in the body, which can affect brain function.
  • Dark urine and pale stools: Dark urine and pale stools can be symptoms of liver diseases. This is due to the build-up of bilirubin in the body, which can cause urine to become dark and stools to become pale.

 

Prevention from Liver Associated Disorders:

 

Prevention from liver diseases includes adopting healthy lifestyle practices such as:

  • Maintain a healthy weight: Obesity and being overweight increase the risk of fatty liver disease, which can lead to liver damage over time. Therefore, it is important to maintain a healthy weight through regular exercise and a balanced diet.
  • Avoid excessive alcohol consumption: Alcohol abuse is a major cause of liver damage and liver diseases such as cirrhosis. Limiting alcohol consumption or avoiding it altogether can help prevent liver damage.
  • Practice safe sex: Unprotected sex and multiple sexual partners can increase the risk of contracting hepatitis B and C, which can cause liver damage.
  • Get vaccinated: Vaccinations for hepatitis A and B are available, and getting vaccinated can help prevent these infections and associated liver damage.
  • Avoid sharing needles: Sharing needles for drug use, tattooing or piercing can increase the risk of hepatitis B and C infections, which can cause liver damage.
  • Practice good hygiene: Practicing good hygiene, such as washing your hands regularly, can help prevent the spread of hepatitis A and E infections.
  • Avoid exposure to toxins: Exposure to toxins such as chemicals, pesticides, and industrial pollutants can cause liver damage. Therefore, it is important to avoid exposure to such toxins and follow safety guidelines in workplaces.
  • Follow a healthy diet: A healthy diet, rich in fruits, vegetables, and whole grains, can help prevent fatty liver disease, which can lead to liver damage over time.
  • Manage medical conditions: Medical conditions such as diabetes and high blood pressure can increase the risk of liver disease. Therefore, managing these conditions through medication, regular check-ups, and lifestyle modifications can help prevent liver damage

Overall, adopting healthy lifestyle practices and taking necessary precautions can help prevent liver diseases and maintain liver health.

 

JAUNDICE:

 

Jaundice is a medical condition that causes yellowing of the skin and whites of the eyes. It is a common symptom of various underlying diseases and conditions that affect the liver, gallbladder, or pancreas. Jaundice occurs when there is a build-up of bilirubin in the body, which is a yellowish pigment that is produced when the liver breaks down old red blood cells. Normally, bilirubin is processed by the liver and excreted from the body through the feces. However, when there is a problem with the liver or bile ducts, bilirubin can accumulate and cause jaundice. Jaundice can affect people of all ages and can be a sign of a serious underlying condition that requires prompt medical attention. Treatment of jaundice depends on the underlying cause and may involve addressing the underlying condition or administering therapies to reduce bilirubin levels in the body.

Jaundice is a common condition in India, and its prevalence varies depending on the underlying causes. According to the National Health Profile 2019, there were 19,115 reported cases of viral hepatitis and 17,207 cases of acute viral hepatitis in India in 2017-18. These cases may result in jaundice, as one of the common symptoms of viral hepatitis is yellowing of the skin and eyes. Additionally, a study conducted by the Indian Council of Medical Research (ICMR) in 2016 reported that the prevalence of jaundice in India was 6.7%, with a higher incidence in rural areas compared to urban areas.

Causes:

Jaundice is not a disease itself but rather a symptom of an underlying condition. There are many possible causes of jaundice, including:

  • Biliary tract obstruction: This occurs when the bile ducts are blocked, preventing the flow of bile from the liver to the intestine. This can be caused by gallstones, tumours, or other conditions.
  • Haemolytic anaemia: This is a condition in which the body destroys red blood cells faster than it can produce them. The excess bilirubin from the breakdown of these cells can lead to jaundice.
  • Gilbert’s syndrome: This is a genetic condition in which the liver is unable to process bilirubin properly, leading to a build-up in the blood and resulting in jaundice.
  • Pancreatic cancer: This type of cancer can cause obstruction of the bile ducts, leading to jaundice.
  • Drug-induced liver injury: Certain medications and toxins can cause liver damage, leading to jaundice.
  • Dubin-Johnson syndrome: This is a rare genetic condition in which the liver is unable to excrete bilirubin properly, leading to a build-up in the blood and resulting in jaundice.

Overall, the causes of jaundice can range from mild and self-limiting conditions to serious and life-threatening diseases.

 

Symptoms:

In addition to yellowing of the skin and eyes, other symptoms of jaundice may include:

  • Dark urine: Jaundice can cause urine to become dark yellow or brown in colour
  • Pale stools: When bilirubin is not properly processed by the liver, it can cause stools to become pale or clay-coloured.
  • Itching: The build-up of bilirubin in the skin can cause severe itching.
  • Fatigue: Jaundice can cause feelings of tiredness and weakness.
  • Abdominal pain: Some people with jaundice may experience pain in the upper right side of the abdomen.
  • Nausea and vomiting: Jaundice can cause feelings of nausea and vomiting.
  • Loss of appetite: Jaundice can cause a loss of appetite and weight loss.
  • Fever: Some people with jaundice may experience a fever 

Complications:

Jaundice can lead to several complications, especially if it is not diagnosed and treated in a timely manner. Here are some of the possible complications of jaundice:

  • Acute liver failure: In some cases, jaundice can lead to acute liver failure. This happens when the liver is unable to perform its functions due to damage or disease. This can cause a build-up of toxins in the blood, leading to confusion, drowsiness, and even coma.
  • Chronic liver disease: Jaundice can be a symptom of chronic liver disease, such as hepatitis B or C, cirrhosis, or alcoholic liver disease. These conditions can cause long-term damage to the liver, leading to complications like liver cancer, fluid build-up in the abdomen, and kidney failure.
  • Gallstones: Jaundice can occur due to blockage of the bile ducts by gallstones. This can cause severe pain in the upper right abdomen, nausea, and vomiting.
  • Pancreatitis: In rare cases, jaundice can be caused by inflammation of the pancreas, known as pancreatitis. This can cause severe pain in the upper abdomen, fever, and nausea.
  • Haemolytic anaemia: Jaundice can also be caused by haemolytic anaemia, a condition in which red blood cells are destroyed faster than they can be replaced. This can cause fatigue, weakness, and shortness of breath.
  • Cerebral oedema: In severe cases of jaundice, a build-up of toxins in the blood can lead to swelling of the brain, known as cerebral oedema. This can cause confusion, seizures, and even coma.

 

FATTY LIVER DISEASE

 

Fatty liver disease, also known as hepatic steatosis, is a condition in which excess fat builds up in the liver. It is becoming increasingly common, and can occur in people who consume alcohol excessively or those who do not drink alcohol at all. Fatty liver disease is often a result of obesity, insulin resistance, or a high-fat diet.

Fatty liver disease is becoming increasingly prevalent in India. According to a study published in the Indian Journal of Gastroenterology in 2019, the prevalence of fatty liver disease in India ranges from 9% to 32%, depending on the study population and diagnostic criteria used. The study also found that the prevalence of fatty liver disease was higher in urban areas and among people with diabetes, obesity, and metabolic syndrome. With the rising incidence of risk factors such as unhealthy diets, sedentary lifestyles, and alcohol consumption, the prevalence of fatty liver disease in India is expected to increase in the coming years.

 

Types:

There are two types of fatty liver disease:

  • Non-alcoholic fatty liver disease (NAFLD): It is the most common type of fatty liver disease and is characterized by excess fat in the liver not related to alcohol consumption. It is usually seen in people who are overweight or have diabetes or high cholesterol levels. NAFLD can be further divided into two subtypes:
    • Simple fatty liver: In this subtype, the fat build-up in the liver cells does not cause inflammation or damage to the liver. It is generally a benign condition and does not progress to more serious liver disease.
    • Non-alcoholic steatohepatitis (NASH): In this subtype, the fat build-up in the liver cells causes inflammation and damage to the liver. NASH can lead to scarring of the liver (fibrosis) and cirrhosis if left untreated.
  • Alcoholic fatty liver disease: It is caused by excessive alcohol consumption and is characterized by excess fat build-up in the liver cells. It can cause inflammation and damage to the liver, leading to more serious liver disease if left untreated.

Both types of fatty liver disease can progress to more serious liver conditions, such as cirrhosis and liver failure. Therefore, it is important to diagnose and manage the condition at an early stage to prevent complications.

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Causes:Bottom of Form

Fatty liver disease is caused by an excessive accumulation of fat in liver cells. The two main types of fatty liver disease, alcoholic fatty liver disease and non-alcoholic fatty liver disease, have different causes.

  • Alcoholic fatty liver disease is caused by excessive alcohol consumption over a long period of time. Alcohol is processed in the liver, and excessive alcohol consumption can lead to an overloading of the liver cells with fat. This can eventually cause inflammation and damage to the liver cells.
  • Non-alcoholic fatty liver disease (NAFLD) can have a variety of causes, including:
    • Obesity: Excess fat in the body can lead to the accumulation of fat in the liver cells.
    • Insulin resistance: When the body becomes resistant to insulin, it can lead to an overproduction of insulin in the pancreas, which can cause an accumulation of fat in the liver cells.
    • Type 2 diabetes: People with type 2 diabetes are more likely to develop NAFLD, as the excess insulin in the body can cause an accumulation of fat in the liver.
    • High cholesterol and triglycerides: High levels of cholesterol and triglycerides in the blood can lead to the accumulation of fat in the liver cells.
    • Rapid weight loss: Losing weight too quickly can cause an accumulation of fat in the liver cells.
    • Medications: Some medications, such as corticosteroids and tamoxifen, can cause an accumulation of fat in the liver cells.
    • Inherited disorders: Certain inherited disorders, such as Wilson’s disease and alpha-1 antitrypsin deficiency, can cause an accumulation of fat in the liver cells.

Symptoms:

Fatty liver disease can cause a variety of symptoms that range from mild to severe. In the early stages, fatty liver disease may not produce any noticeable symptoms. However, as the condition progresses, some people may experience the following symptoms:

  • Fatigue: Feeling tired and exhausted even after getting adequate rest is a common symptom of fatty liver disease.
  • Abdominal discomfort: Some people with fatty liver disease may experience discomfort or pain in the upper right quadrant of the abdomen. This is caused by an enlarged liver.
  • Loss of appetite: People with fatty liver disease may lose their appetite, and as a result, they may lose weight unintentionally.
  • Jaundice: In some cases, the skin and the whites of the eyes may turn yellow, a condition known as jaundice. This occurs when the liver is unable to properly process bilirubin, a waste product that is produced when old red blood cells are broken down.
  • Swelling in the legs and ankles: Fatty liver disease can cause fluid buildup in the body, leading to swelling in the legs and ankles.
  • Mental confusion: People with severe fatty liver disease may experience mental confusion and forgetfulness due to the accumulation of toxins in the bloodstream.
  • Spider veins: The development of spider veins on the skin can be a symptom of advanced fatty liver disease.

Complications:

Fatty liver disease, if left untreated or uncontrolled, can lead to serious complications. Some of the complications of fatty liver disease are:

  • Cirrhosis: This is a serious condition in which the liver is permanently damaged and cannot function properly. Cirrhosis is the end stage of liver disease and can cause liver failure. In cirrhosis, scar tissue replaces healthy liver tissue, which impairs liver function and can cause liver failure.
  • Liver cancer: Fatty liver disease increases the risk of developing liver cancer. Liver cancer can develop in people with non-alcoholic fatty liver disease, especially those with cirrhosis.
  • Hepatic encephalopathy: This is a serious condition in which the liver is unable to filter toxins from the blood, which can lead to confusion, memory loss, and other neurological symptoms.
  • Portal hypertension: Fatty liver disease can cause high blood pressure in the portal vein, which carries blood from the intestines to the liver. Portal hypertension can cause the veins in the oesophagus, stomach, and intestines to swell and burst, which can be life-threatening.
  • Type 2 diabetes: Fatty liver disease is strongly associated with type 2 diabetes. Insulin resistance, which is a hallmark of type 2 diabetes, is also a common feature of fatty liver disease.
  • Cardiovascular disease: Fatty liver disease is associated with an increased risk of cardiovascular disease, such as heart attacks and strokes.

 

HEPATITIS:

 

Hepatitis is a medical condition characterized by inflammation of the liver. It is most commonly caused by a viral infection, but it can also result from exposure to drugs, toxins, or other infections. The inflammation of the liver can lead to damage and scarring, affecting the liver’s ability to function properly. There are different types of hepatitis, including hepatitis A, B, C, D, and E, each caused by a different virus. Some forms of hepatitis can be prevented through vaccination, while others can be treated with antiviral medications. If left untreated, hepatitis can lead to serious health complications such as liver damage, cirrhosis, and liver cancer.

 

Hepatitis is a significant public health problem in India. According to the World Health Organization (WHO), an estimated 40 million people in India are infected with hepatitis B, and about 6 to 12 million people are infected with hepatitis C. Additionally, an estimated 15-20% of acute hepatitis cases in India are caused by hepatitis A virus. The prevalence of hepatitis varies across different regions of India and is influenced by factors such as socio-economic status, access to healthcare, and vaccination coverage. High-risk groups for hepatitis in India include people who inject drugs, healthcare workers, and those who engage in unsafe sexual practices.

 

Types:

There are several types of hepatitis, which can be broadly classified into five types: A, B, C, D, and E. Each type of hepatitis is caused by a different virus, and each virus can affect the liver in different ways:

 

  1. Hepatitis A (HAV): This is a highly contagious viral infection that spreads through contaminated food and water or through close contact with an infected person. It causes acute hepatitis, which usually resolves on its own without any long-term liver damage.
  2. Hepatitis B (HBV): This is a viral infection that spreads through blood, semen, or other body fluids of an infected person. HBV can cause both acute and chronic hepatitis, and chronic infection can lead to serious liver diseases such as cirrhosis and liver cancer.
  3. Hepatitis C (HCV): This is a viral infection that spreads through blood-to-blood contact with an infected person. HCV can cause both acute and chronic hepatitis, and chronic infection can also lead to serious liver diseases such as cirrhosis and liver cancer.
  4. Hepatitis D (HDV): This is a viral infection that only affects people who are already infected with HBV. HDV can cause both acute and chronic hepatitis, and chronic infection can lead to serious liver diseases such as cirrhosis and liver cancer.
  5. Hepatitis E (HEV): This is a viral infection that spreads through contaminated food and water or through close contact with an infected person. HEV usually causes acute hepatitis, which usually resolves on its own without any long-term liver damage, but it can be serious in pregnant women.

 

Each type of hepatitis has its own set of symptoms, modes of transmission, and treatment options. It is important to get diagnosed and treated early to prevent further liver damage.

 

Causes:

Hepatitis is caused by a variety of factors including viral infections, alcohol consumption, autoimmune disorders, and certain medications or toxins. The causes of the different types of hepatitis are:

  • Viral hepatitis: It is caused by a viral infection that attacks the liver. The most common types of viral hepatitis are hepatitis A, B, C, D, and E.
    • Hepatitis A: It spreads through contaminated food or water or by close contact with an infected person.
    • Hepatitis B: It spreads through contact with infected blood or body fluids such as through unprotected sex, sharing needles or from mother to baby during childbirth.
    • Hepatitis C: It spreads through contact with infected blood, such as through sharing needles, or from mother to baby during childbirth.
    • Hepatitis D: It occurs only in people who are already infected with hepatitis B, and can make the liver disease more severe.
    • Hepatitis E: It spreads through contaminated food or water, particularly in areas with poor sanitation.
  • Alcoholic hepatitis: It is caused by excessive alcohol consumption over a long period of time.
  • Autoimmune hepatitis: It is caused when the body’s immune system attacks the liver cells.
  • Drug-induced hepatitis: It is caused by certain medications or toxins that damage the liver cells.
  • Non-alcoholic fatty liver disease (NAFLD): It is caused by the accumulation of fat in the liver cells, which can lead to inflammation and liver damage.

 

Symptoms:

The symptoms of hepatitis can vary depending on the type of virus and the stage of the disease. Some people may experience no symptoms at all, while others may develop severe symptoms. The following are the most common symptoms associated with hepatitis:

 

  • Fatigue: Feeling excessively tired or weak is a common symptom of hepatitis.
  • Jaundice: Yellowing of the skin and eyes due to the build-up of bilirubin in the bloodstream.
  • Abdominal pain: Pain in the upper right side of the abdomen or around the liver.
  • Nausea and vomiting: Feeling sick to your stomach and vomiting are common symptoms of hepatitis.
  • Loss of appetite: A reduced desire to eat or feeling full after eating only a small amount.
  • Joint pain: Some people with hepatitis may experience joint pain.
  • Dark urine: Urine may appear darker than normal due to the build-up of bilirubin.
  • Clay-coloured stool: Stool may appear pale or clay-coloured due to the lack of bilirubin.
  • Fever: A low-grade fever may occur with acute hepatitis.
  • Itching: Itching may occur due to the build-up of bile products in the bloodstream.

 

 

Complications:

 

Hepatitis can lead to various complications depending on the type and severity of the infection. Some of the possible complications include:

 

  • Liver Cirrhosis: This is a serious condition in which the liver becomes severely scarred and its ability to function properly is impaired. Chronic hepatitis B and C are the most common causes of liver cirrhosis.
  • Liver Failure: This occurs when the liver is no longer able to function properly. In severe cases, a liver transplant may be required.
  • Hepatocellular Carcinoma: This is a type of liver cancer that can develop in people with chronic hepatitis B or C.
  • Ascites: This is the accumulation of fluid in the abdomen, which can occur in people with advanced liver disease.
  • Encephalopathy: This is a condition in which toxins build up in the blood and affect brain function. It can occur in people with advanced liver disease.
  • Portal Hypertension: This is a condition in which there is increased pressure in the veins that supply blood to the liver. It can cause complications such as varices, which are swollen veins in the oesophagus or stomach that can rupture and cause life-threatening bleeding.
  • Kidney Failure: In rare cases, hepatitis B or C can cause kidney failure.

 

 

 

CIRRHOSIS

 

Cirrhosis is a chronic and progressive liver disease in which healthy liver tissue is replaced with scar tissue, ultimately leading to loss of liver function. The liver is responsible for filtering toxins from the blood, producing bile to aid in digestion, and regulating blood sugar levels. As cirrhosis progresses, the liver becomes less able to perform these vital functions, leading to serious health complications. Cirrhosis is often caused by chronic alcohol abuse, viral hepatitis, or non-alcoholic fatty liver disease. It is a serious and potentially life-threatening condition that requires ongoing medical treatment and lifestyle changes to manage.

 

The prevalence of cirrhosis in India is not precisely known, but studies suggest that it is on the rise. One study conducted in Delhi found that the prevalence of cirrhosis increased from 0.8% in 1991 to 4.5% in 2004. Another study in Chennai found that the prevalence of cirrhosis among patients with liver disease was 22%. The major causes of cirrhosis in India are alcohol consumption, viral hepatitis (particularly hepatitis B and C), and non-alcoholic fatty liver disease. Other factors that may contribute to the development of cirrhosis include obesity, diabetes, and certain genetic disorders.

 

Types:

 

There are mainly two types of cirrhosis, namely:

  • Compensated Cirrhosis: In this type of cirrhosis, the liver is still able to function to some extent, and the damage can be reversed with proper treatment and lifestyle changes.
  • Decompensated Cirrhosis: This type of cirrhosis is a more advanced stage where the liver has sustained extensive damage, and its ability to function is severely impaired. It is irreversible and requires more aggressive medical management, including liver transplantation.

 

Causes:

There are several causes of cirrhosis, including:

  • Alcohol abuse: Long-term and excessive consumption of alcohol is a leading cause of cirrhosis. The liver is responsible for breaking down alcohol, and over time, excessive drinking can damage liver cells and cause scarring.
  • Hepatitis B and C: These viral infections can cause inflammation in the liver and over time, lead to cirrhosis.
  • Non-alcoholic fatty liver disease (NAFLD): This condition occurs when there is a build-up of fat in the liver, which can cause inflammation and scarring.
  • Autoimmune hepatitis: This is a condition where the immune system attacks the liver, causing inflammation and scarring.
  • Inherited diseases: Certain inherited conditions such as hemochromatosis, Wilson’s disease, and alpha-1 antitrypsin deficiency can lead to cirrhosis.
  • Other causes: Other causes of cirrhosis include biliary obstruction, prolonged exposure to toxins, and certain medications.

 

Symptoms:

Cirrhosis is a progressive liver disease that develops gradually over time. In its early stages, cirrhosis often does not present any symptoms. As the disease progresses, however, symptoms can become more noticeable and severe. Some of the most common symptoms of cirrhosis include:

  • Fatigue: Feeling tired or weak is common in people with cirrhosis. This is because the liver plays a key role in producing energy for the body, and as it becomes damaged, it becomes less efficient at performing this function.
  • Jaundice: Yellowing of the skin and eyes is a classic sign of liver disease. In cirrhosis, the liver becomes unable to properly filter bilirubin, a waste product that gives urine its yellow colour. As bilirubin builds up in the blood, it can cause the skin and eyes to appear yellow.
  • Swelling: Cirrhosis can cause fluid to accumulate in the legs, ankles, and feet. This is called oedema and is caused by increased pressure in the blood vessels of the liver.
  • Itching: As bile builds up in the blood due to liver dysfunction, it can cause severe itching in the skin.
  • Loss of appetite: As the liver becomes damaged, it can lead to a loss of appetite and a decrease in food intake.
  • Weight loss: As the body becomes less able to metabolize nutrients, weight loss can occur.
  • Nausea and vomiting: As the liver becomes less efficient at processing toxins, it can lead to feelings of nausea and vomiting.
  • Abdominal pain and bloating: As fluid builds up in the abdomen, it can cause pain and bloating.
  • Confusion and cognitive changes: In advanced cirrhosis, toxins can build up in the blood and affect brain function, leading to confusion, memory loss, and difficulty concentrating.

 

Complications:

Cirrhosis can lead to several complications, some of which can be life-threatening. Here are some of the possible complications of cirrhosis:

  • Portal hypertension: Cirrhosis can cause an increase in pressure in the portal vein, which carries blood from the intestines, pancreas, and spleen to the liver. This can lead to the formation of varices, which are enlarged veins in the oesophagus, stomach, or rectum. Varices can rupture and cause severe bleeding.
  • Ascites: Cirrhosis can also cause a build-up of fluid in the abdomen, a condition called ascites. This can lead to swelling, discomfort, and difficulty breathing.
  • Hepatic encephalopathy: This is a condition in which toxins that are normally processed by the liver build up in the bloodstream and affect brain function. Symptoms can include confusion, forgetfulness, mood changes, and even coma.
  • Hepatorenal syndrome: Cirrhosis can also affect kidney function, leading to a condition called hepatorenal syndrome. This can cause a decrease in urine output and electrolyte imbalances, which can be life-threatening.
  • Liver cancer: Long-term damage to the liver can increase the risk of developing liver cancer.
  • Malnutrition: Cirrhosis can interfere with the body’s ability to absorb nutrients from food, which can lead to malnutrition and weight loss.
  • Infections: Cirrhosis can weaken the immune system, making it more difficult for the body to fight off infections. People with cirrhosis are at increased risk of developing infections such as pneumonia and sepsis.

 

LIVER CANCER:

 

Liver cancer, also known as hepatocellular carcinoma (HCC), is a type of cancer that begins in the cells of the liver. It is one of the most common cancers in the world, with over 800,000 new cases diagnosed every year. Liver cancer is more common in men than in women and usually affects people over the age of 50. It is often diagnosed in the later stages, when the cancer has spread to other parts of the body, making treatment more difficult.

Liver cancer can be either primary or secondary. Primary liver cancer starts in the cells of the liver itself, while secondary liver cancer starts in other parts of the body and spreads to the liver. The most common type of primary liver cancer is hepatocellular carcinoma, which accounts for 75-85% of cases. Other types of primary liver cancer include cholangiocarcinoma and angiosarcoma. Secondary liver cancer is more common than primary liver cancer and is usually caused by the spread of cancer from the colon, pancreas, or other parts of the body.

Liver cancer, also known as hepatocellular carcinoma (HCC), is one of the leading causes of cancer-related deaths globally. In India, liver cancer is also a major health concern. According to the Indian Council of Medical Research (ICMR), liver cancer is the sixth most common cancer in India, and its incidence is increasing. The estimated incidence rate of liver cancer in India is around 4.7 per 100,000 population, and it is more common in men than women. The high prevalence of hepatitis B and C infections, alcohol consumption, and obesity are the major risk factors for liver cancer in India.

Types:

There are several types of liver cancer, which can be categorized based on their origin and characteristics. The most common types of liver cancer are:

  • Hepatocellular carcinoma (HCC): This is the most common type of liver cancer, accounting for around 75% of all cases. HCC develops in the main type of liver cells called hepatocytes.
  • Cholangiocarcinoma: This type of liver cancer develops in the bile ducts, which are the tubes that carry bile from the liver to the gallbladder and small intestine.
  • Hepatoblastoma: This type of liver cancer is rare and usually affects children under the age of 5.
  • Angiosarcoma and hemangiosarcoma: These are rare types of liver cancer that develop in the blood vessels of the liver.
  • Secondary liver cancer: This is not a type of primary liver cancer, but rather cancer that has spread to the liver from other parts of the body. The most common types of cancer that spread to the liver include colon, lung, and breast cancer.

Causes:

The exact cause of liver cancer is not always clear, but there are several risk factors that can increase a person’s chance of developing the disease. Some of the common causes of liver cancer include:

  • Chronic viral hepatitis: Long-term infection with hepatitis B or hepatitis C virus can lead to liver cancer.
  • Cirrhosis: Cirrhosis is a condition in which healthy liver tissue is replaced with scar tissue. It is commonly caused by alcohol abuse, viral hepatitis, and non-alcoholic fatty liver disease. Cirrhosis increases the risk of liver cancer.
  • Alcohol: Excessive alcohol consumption can damage liver cells and increase the risk of liver cancer.
  • Non-alcoholic fatty liver disease (NAFLD): NAFLD is a condition in which excess fat accumulates in the liver, leading to inflammation and scarring. This can increase the risk of liver cancer.
  • Inherited liver diseases: Certain genetic conditions such as hemochromatosis, Wilson’s disease, and alpha-1 antitrypsin deficiency can increase the risk of liver cancer.
  • Exposure to toxins: Exposure to certain chemicals and toxins, such as aflatoxins, can increase the risk of liver cancer.
  • Diabetes: People with diabetes have an increased risk of developing liver cancer, possibly due to the link between diabetes and NAFLD.

It’s important to note that not everyone with these risk factors will develop liver cancer, and some people without any of these risk factors can still develop the disease.

 

Symptoms:

The symptoms of liver cancer may not show up in the early stages, and in some cases, there may be no symptoms at all. However, as the cancer progresses, some common symptoms may include:

  • Abdominal pain: Pain in the upper right side of the abdomen may occur, which can sometimes radiate to the back or shoulder.
  • Jaundice: Yellowing of the skin and whites of the eyes may occur due to the build-up of bilirubin in the blood.
  • Fatigue: Feeling weak and tired is a common symptom of liver cancer.
  • Weight loss: Unexplained weight loss may occur due to loss of appetite, nausea, and vomiting.
  • Loss of appetite: A feeling of fullness or loss of appetite may occur due to the tumour growing and taking up space in the abdomen.
  • Nausea and vomiting: These symptoms may occur due to the liver not functioning properly.
  • Swelling: Swelling of the abdomen or legs may occur due to fluid build-up.

Complications:

The complications of liver cancer can vary depending on the stage and severity of the disease. Some of the common complications include:

  • Spread of cancer: Liver cancer can spread to other parts of the body such as the lungs and bones, leading to secondary cancers.
  • Liver failure: When the liver is no longer able to function properly due to cancerous cells replacing healthy cells, liver failure can occur.
  • Jaundice: Liver cancer can block the bile ducts, causing a build-up of bilirubin in the bloodstream which leads to yellowing of the skin and eyes.
  • Ascites: Liver cancer can cause a build-up of fluid in the abdomen, leading to abdominal swelling and discomfort.
  • Portal hypertension: Liver cancer can increase pressure in the portal vein, leading to complications such as internal bleeding, varices, and splenomegaly.
  • Malnutrition: Liver cancer can lead to a decreased appetite, weight loss, and malnutrition due to the body’s inability to properly process nutrients.
  • Infection: Liver cancer can weaken the immune system, making the body more susceptible to infections.

It is important to note that early detection and treatment of liver cancer can help prevent or minimize these complications.

 

HEMOCHROMATOSIS

 

Hemochromatosis is a hereditary condition characterized by the body’s inability to regulate the absorption of iron from the diet. This leads to a build-up of iron in various organs and tissues of the body, especially the liver, pancreas, and heart. Over time, this excess iron accumulation can lead to damage and dysfunction of these organs. Hemochromatosis is one of the most common genetic disorders, and if left untreated, it can cause serious complications such as liver disease, diabetes, heart disease, and arthritis. It is important to diagnose and manage this condition early to prevent these complications.

Hemochromatosis is a rare genetic disorder, and its prevalence in India is not well established. However, it is believed to be less common in India than in western countries. This may be due to differences in genetic factors and environmental factors such as diet and lifestyle. Additionally, hemochromatosis may be underdiagnosed in India due to a lack of awareness among the public and healthcare professionals. Further research is needed to determine the prevalence of hemochromatosis in India.

Types and Causes:

There are two types of hemochromatosis:

  • Primary hemochromatosis: This is an inherited form of the condition that is caused by mutations in the HFE gene. The HFE gene helps regulate the absorption of iron from food. If both parents pass on the mutated HFE gene, the child may develop hemochromatosis.
  • Secondary hemochromatosis: This type of hemochromatosis is caused by other medical conditions or factors that can lead to iron overload. These may include frequent blood transfusions, alcohol abuse, and certain blood disorders like thalassemia.

In both types of hemochromatosis, excess iron builds up in the body’s tissues over time, leading to organ damage and an increased risk of cancer.

 

Symptoms:

Some of the common symptoms of hemochromatosis are:

  • Fatigue: Feeling tired and lacking energy is one of the most common symptoms of hemochromatosis. Excess iron can build up in various organs and tissues, leading to dysfunction and reduced energy levels.
  • Joint pain: Hemochromatosis can cause pain, stiffness, and swelling in the joints. This is due to iron deposition in the joints, leading to inflammation and damage.
  • Abdominal pain: Excess iron in the liver can cause inflammation and damage, leading to abdominal pain and discomfort. This can also cause enlargement of the liver, leading to a feeling of fullness and discomfort.
  • Skin discoloration: Hemochromatosis can cause a bronze or greyish-brown skin discoloration, especially on the face, neck, and hands.
  • Diabetes: Hemochromatosis can cause diabetes by damaging the pancreas, which is responsible for producing insulin.
  • Impotence and loss of sex drive: Excess iron can also accumulate in the testes and ovaries, leading to reduced sex drive and impotence in men.
  • Irregular menstruation: In women, hemochromatosis can lead to irregular periods and infertility.
  • Heart problems: Hemochromatosis can cause various heart problems, such as irregular heartbeat, enlarged heart, and heart failure.
  • Liver problems: Hemochromatosis can cause liver problems, such as cirrhosis, liver cancer, and liver failure.
  • Arthritis: Hemochromatosis can cause a type of arthritis called chondrocalcinosis, in which calcium pyrophosphate crystals build up in the joints, leading to inflammation and pain.

Complications:

Hemochromatosis, if left untreated, can lead to several complications, including:

  • Liver disease: Iron accumulation in the liver can lead to inflammation, scarring, and even liver failure. This condition is called cirrhosis.
  • Heart problems: Iron overload in the heart can cause heart problems such as irregular heartbeats, heart attack, or congestive heart failure.
  • Arthritis: Iron deposits can accumulate in the joints, leading to arthritis, which can cause pain, swelling, and stiffness.
  • Diabetes: Excess iron in the pancreas can damage insulin-producing cells, leading to diabetes.
  • Skin discoloration: A bronze or grey colour of the skin, particularly on the face, is a common sign of hemochromatosis.
  • Hypothyroidism: Iron deposition in the thyroid gland can cause it to under-function, leading to hypothyroidism.
  • Impotence: In men, iron overload can lead to impotence or a decreased sex drive.
  • Adrenal insufficiency: Iron deposition in the adrenal glands can impair their function, leading to adrenal insufficiency.
  • Increased risk of cancer: Iron overload has been associated with an increased risk of liver cancer and other types of cancer.
  • Joint pain: Accumulation of iron in the joints can cause joint pain and swelling.

 

WILSON’S DISEASE

 

Wilson’s disease is a rare genetic disorder that affects copper metabolism in the body. It is an autosomal recessive disorder, which means that a person must inherit two copies of the defective gene, one from each parent, to develop the condition. This disease causes copper to accumulate in various organs, especially the liver, brain, and eyes, which can lead to severe damage if left untreated. Wilson’s disease can be diagnosed at any age, but most people are diagnosed between the ages of 5 and 35 years old. The disease affects both males and females equally, and it is estimated that it affects 1 in 30,000 individuals worldwide.

Causes:

Wilson’s disease is caused by a genetic mutation that results in the accumulation of copper in the body. The mutation affects the ATP7B gene, which plays a role in the metabolism of copper in the liver. Normally, the liver produces a protein called ceruloplasmin, which carries copper through the bloodstream and into the liver for processing. In people with Wilson’s disease, the ATP7B gene mutation causes the liver to be unable to process copper properly, resulting in a build-up of copper in the liver and other organs such as the brain, kidneys, and eyes. This excess copper can cause damage to these organs and lead to the symptoms of Wilson’s disease. The disease is inherited in an autosomal recessive pattern, meaning that a person must inherit two copies of the mutated gene (one from each parent) in order to develop the disease.

Symptoms:

The symptoms of Wilson’s disease can vary depending on which organs are affected by copper accumulation. Some of the symptoms are:

  • Liver symptoms: Liver symptoms of Wilson’s disease include abdominal pain, jaundice, and liver failure. In some cases, Wilson’s disease can cause an enlarged liver and spleen.
  • Neurological symptoms: Wilson’s disease can cause a variety of neurological symptoms, including tremors, difficulty speaking or swallowing, muscle stiffness, and coordination problems.
  • Psychiatric symptoms: Some people with Wilson’s disease may experience psychiatric symptoms such as depression, anxiety, and mood swings.
  • Eye symptoms: Copper accumulation in the eyes can cause a condition called Kayser-Fleischer rings, which are brownish-green rings around the cornea. This can lead to vision problems or blindness.
  • Haematological symptoms: In rare cases, Wilson’s disease can cause haemolytic anaemia, a condition in which red blood cells are destroyed faster than they can be produced.
  • Other symptoms: Other symptoms of Wilson’s disease can include fatigue, abdominal swelling, and osteoporosis.

Complications:

Here are some of the complications that can arise due to Wilson’s disease:

  • Liver disease: Wilson’s disease causes copper to accumulate in the liver, leading to liver damage and liver disease. If left untreated, the liver can become severely damaged, and cirrhosis may develop, which can be life-threatening.
  • Neurological problems: Copper accumulation in the brain can lead to neurological problems such as tremors, difficulty speaking or swallowing, and difficulty walking or controlling movements. Seizures, personality changes, and dementia can also occur in some cases.
  • Psychiatric disorders: Wilson’s disease can also cause psychiatric disorders, including depression, anxiety, and psychosis.
  • Eye problems: Copper accumulation can cause a ring-like deposit around the cornea of the eye, which is called Kayser-Fleischer rings. These rings are a characteristic sign of Wilson’s disease, but they are not always present.
  • Osteoporosis: Copper accumulation in the bones can lead to osteoporosis, which is a condition in which the bones become weak and brittle and are more likely to fracture.
  • Kidney problems: Wilson’s disease can also affect the kidneys, leading to kidney damage and kidney failure in severe cases.
  • Heart problems: Copper accumulation can cause heart problems, including an irregular heartbeat and an enlarged heart.

 

CHOLANGITIS

 

Cholangitis is a condition characterized by inflammation of the bile ducts. The bile ducts are responsible for carrying bile from the liver and gallbladder to the small intestine for digestion. When the bile ducts become inflamed, the flow of bile can be obstructed, leading to a range of symptoms. Cholangitis can be acute, occurring suddenly and severely, or chronic, developing gradually over time. This condition requires prompt medical attention and treatment to prevent serious complications such as liver failure and sepsis.

Types:

There are two types of cholangitis:

  • Acute cholangitis: It is a sudden inflammation of the bile duct, which is usually caused by a bacterial infection.
  • Chronic cholangitis: It is a long-term inflammation of the bile duct, which can be caused by a number of factors such as recurrent infections, blockages, or autoimmune diseases. Chronic cholangitis can lead to scarring and narrowing of the bile ducts, which can cause complications such as liver damage and infections.

Causes:

Cholangitis can be caused by a variety of factors, which include:

  • Bile duct blockage: A blockage in the bile ducts can cause bile to build up in the liver, leading to infection and inflammation.
  • Bacterial infections: Bacteria can infect the bile ducts, leading to inflammation and cholangitis. Bacteria can enter the bile ducts through the bloodstream, the biliary system, or from nearby organs.
  • Autoimmune disorders: Certain autoimmune disorders, such as primary sclerosing cholangitis and autoimmune hepatitis, can cause inflammation and damage to the bile ducts.
  • Trauma: Trauma to the bile ducts can cause cholangitis. This can occur during surgery or from an injury.
  • Parasitic infections: Certain parasites, such as liver flukes, can infect the bile ducts and cause inflammation and cholangitis.
  • Gallstones: In some cases, gallstones can become lodged in the bile ducts, causing blockage and cholangitis.
  • Tumours: Tumours in the bile ducts or nearby organs can cause cholangitis by blocking the flow of bile.
  • Genetic factors: Some genetic conditions, such as cystic fibrosis, can cause cholangitis.

Symptoms:

The symptoms of cholangitis can range from mild to severe and can include:

  • Abdominal pain: Pain in the upper right side of the abdomen is common in cholangitis. The pain may be constant or intermittent and can be severe.
  • Jaundice: This is a condition that causes yellowing of the skin and eyes due to the build-up of bilirubin in the blood. In cholangitis, jaundice can occur due to blockage of the bile ducts.
  • Fever: A fever is a common symptom of cholangitis and can be accompanied by chills and sweating.
  • Nausea and vomiting: These symptoms can occur due to the build-up of bile in the body, which can cause digestive problems.
  • Itching: This can occur due to the build-up of bile in the blood.
  • Fatigue: Cholangitis can cause fatigue and weakness due to the build-up of toxins in the blood.
  • Dark urine: The urine may become dark in colour due to the build-up of bilirubin in the blood.
  • Pale stools: The stools may become pale in colour due to the lack of bile in the digestive system.
  • Confusion: In severe cases of cholangitis, confusion and disorientation can occur due to the build-up of toxins in the blood.

Complications:

If left untreated, cholangitis can lead to serious complications, such as:

  • Septic shock: This can occur when the bacterial infection spreads to the bloodstream and causes a dangerous drop in blood pressure.
  • Liver abscess: Pus-filled pockets can form in the liver as a result of the infection.
  • Biliary cirrhosis: Chronic inflammation and damage to the bile ducts can lead to scarring and hardening of the liver.
  • Sepsis: This is a potentially life-threatening condition that can occur when an infection in one part of the body spreads throughout the bloodstream.
  • Death: In severe cases, cholangitis can lead to death if not treated promptly and effectively

 

Role of Neurotherapy in Liver associated disorders:

 

  • With the help of neurotherapy, symptomatic treatment is provided that involves applying pressure to specific points on the body in order to alleviate pain and other symptoms. The liver plays a crucial role in producing and regulating various substances in the body, including heparin. Heparin is a naturally occurring anticoagulant that helps to prevent blood clots from forming in the body. It is primarily produced in the liver and stored in the liver and lungs. The liver also plays a role in metabolizing heparin. When heparin is administered as a medication, it is typically given as an injection and is rapidly metabolized by the liver. This means that the liver helps to clear heparin from the bloodstream, which is important for preventing bleeding complications. However, in individuals with liver disease, the production and metabolism of heparin can be impaired. This can lead to a decrease in the levels of heparin in the body, which can increase the risk of blood clots. Thus, in this case Heparin treatment is given to dissolve the causes and symptoms.